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    Orthopaedic medicine is a specialty devoted to the evaluation, diagnosis and non-operative treatment for pain caused by musculoskeletal diseases to aid in pain management. Diagnostic modalities include a comprehensive history, a detailed and specific physical examination, radiologic evaluations and local anesthetic blocks for pain treatment. Therapeutic modalities for pain management encompass manipulations, corticosteroid or proliferant injections with and without fluoroscopic guidance, therapeutic exercise and use of pharmaceutical, nutriceutical, herbal and/or homeopathic based pain treatment.

    The evolution began in 1741 when Nicholas Andre, at that time a Professor of Medicine at the University of Paris, coined the word “orthopaedic”. He published a book with the same title. The etymology of orthopaedic is based on two greek roots: “orthos” and “paedia” which translate to “straight” and “rearing of children” respectively. His illustration of a staff that is used to straighten a growing tree is known world wide.

    For more than two centuries orthopaedists were physicians or surgeons concerned with musculoskeletal deformities: scoliosis, infections of bones and joints, poliomyelitis and congenital defects such as Erb’s palsy, clubfoot and hip dislocations. Until the 20th century most orthopaedic treatments were manipulations and mechanical support with braces and plaster casts.

    The American Orthopaedic Association was founded in 1887. The separation of orthopaedic surgery from general surgery took place in 1934 with the establishment of a separate board. According to the late Dr. Cyriax, orthopaedic medicine was established in 1929. The American Association of Orthopaedic Medicine was founded in 1982.

    The accumulation of knowledge remains constant. The evolution of pain management continues.